Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 4704148535 | MI |
NPI | 1033220025 |
---|---|
Provider Name | Ms. Nancy S. Westendorp |
First Address | Holland, MI 49423-4918 |
Second Address | Grand Rapids, MI 49503-4502 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |